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Intellectual disability

disability; developmental; differences; delay; global; intellectual; disability; Down; syndrome; Fragile X; autism; Prader-Willi; Williams; Angelman; mental; retardation; handicapped; mentally; handicap; pervasive; disorder; slow; learner; alcohol;

Children develop and learn at different rates and in different ways. However, some children will learn at a much slower rate than other children of the same age. This may be due to an intellectual disability.

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Intellectual disability can be linked with a number of genetic or inherited conditions such as Down syndrome, autism, Prader Willi syndrome and Fragile X syndrome. It might be caused by a head injury or illness, or exposure to alcohol during pregnancy. For some no cause is found.

All people with intellectual disability can learn and develop. Many services are available to support people with disabilities and their families. 

Words that are often used

  • Developmental delay is a term that might be used if your child is developing more slowly than other children of the same age in one or more areas of development.
  • Global developmental delay means that your child is developing more slowly than other children of the same age in all areas of development.
  • Areas of development is a term used by professionals to talk about different types of learning. Some major areas of development are communication (talking and listening), movement (gross and fine motor movement), feeding and self care, thinking, social, emotional and sensory development.
  • Sensory development is the development of the different senses of touch, taste, smell, vision and hearing as well as movement awareness. For example, as children get older, they come to understand that all food does not taste the same. Lollies are sweet and lemons are sour. Over time, children combine information from the senses to get a better idea of what is happening around them.
  • Sensory integration describes a child's ability to organise and respond to information received through the senses of touch, taste, smell, vision, hearing and movement. Children need to be able to organise and respond to sensory information before they can develop more complex thinking skills and behaviours.
  • Delayed intellectual development is a term used to describe slow learning in a young child (usually below the age of five). This term is often used when professionals are not sure if the slowness is temporary or permanent.
  • Intellectual disability means that a child is expected to be a slow learner for life. Many professionals will not use the term 'intellectual disability' unless the child has been formally assessed. Usually, this type of assessment is done by a psychologist.

What is intellectual disability?

  • Intellectual disability means that a child learns more slowly than other children of the same age and has difficulties learning the range of skills that will be needed to live and work in the community. These include communication, self-care, social and personal safety skills.
  • Children with an intellectual disability will have limitations in thinking skills, including the ability to reason (working things out) and remember.
  • They will have difficulties with attention and organising information.
  • Children with an intellectual disability have trouble seeing how things or how events relate to each other. For example, they may find it difficult to understand that forks, knives and spoons all belong to a bigger category called cutlery.
  • In order to learn effectively, children with an intellectual disability will need certain types of structure and support.

Professionals usually talk about intellectual developmental delay, rather than intellectual disability, when a child is very young. Sometimes a child's learning will be slow for a while due to a serious illness, a change in family circumstances or a temporary hearing loss. But these children may later catch up on learning and then continue to develop as other children of the same age.

However, if a significant learning delay continues as the child gets older and this delay affects a number of areas of the child's development, professionals will begin to speak of an intellectual disability. This means that they expect the child to continue to learn at a slower rate than other children of the same age into adulthood. It is good practice for professionals to formally assess the child before diagnosing an intellectual disability.

Causes of intellectual disability

It is not always possible to explain why a person has an intellectual disability. However, some of the causes of intellectual disability include:

  • an illness experienced by the mother during pregnancy, such as rubella
  • exposure to alcohol during pregnancy
  • problems that occur during pregnancy or during birth
  • childhood illnesses that have lasting effects on development, such as meningitis
  • some types of infection
  • an injury to the brain or head
  • lack of oxygen during birth or as a result of an accident (near drowning or suffocation).
  • genetic conditions, such as Down syndrome, Fragile X syndrome, Prader-Willi syndrome, Williams syndrome and Angelman syndrome.

It can also be part of some developmental disabilities, such as autism and pervasive developmental disorder.

In addition, there is a higher rate of intellectual disability associated with some medical conditions, such as epilepsy.

Signs of intellectual disability

  • Children with an intellectual disability need more structure and support to develop basic skills, such as understanging, talking and dressing.
  • Many parents notice that their children take longer to remember familiar people or show an interest in the things around them.
  • Children develop at different rates and in different ways. They usually develop simple skills before they learn more complex skills. For this reason, an intellectual disability might not be obvious until a child gets older.
  • Health professionals use developmental assessments to check a child's progress in relation to what is expected for each age level. These assessments will show problems in different developmental areas. Certain types of developmental problems are signs of developmental delay or intellectual disability.

As a guide, children should develop the following skills at about these ages:

By 6 months, babies will:

  • from birth, turn their head toward sounds and movement
  • reach up to hold feet when lying on their backs
  • watch an adult's face when feeding
  • smile at familiar faces and voices
  • cry when uncomfortable or hungry
  • make many different sounds, including cooing, chuckling and babbling
  • laugh at games such as an adult pulling faces or blowing raspberries
  • look and reach for objects
  • hold and shake a rattle
  • put everything in their mouths.

Between 6 months to 1 year, babies begin to move about to explore the world around them and:

  • move from sitting with support to sitting alone
  • roll over from their tummy to their back
  • begin to creep, crawl or shuffle on their bottom
  • pull on or push against adult hands or furniture to reach a standing position
  • become disturbed by strangers and may cling to familiar people
  • show affection to familiar people
  • turn and look up when they hear their name
  • make distinct and separate sounds
  • imitate some sounds and words such as 'dada' and 'bubba'
  • pat and poke objects when playing
  • pass objects from hand to hand
  • enjoy dropping things and watching them fall
  • look for things that have been hidden or dropped
  • play turn-taking games like peek-a-boo
  • respond (sometimes) to the word 'No!'.

Between 1 to 2 years, children:

  • begin to walk
  • feed themselves
  • push and pull toys while walking
  • become less fearful of strangers
  • play alone or alongside other children
  • defend their own things: do not understand sharing
  • wave goodbye
  • point or make noises to indicate wants
  • enjoy a picture book
  • shake head for 'No!'
  • use several recognisable words and try to say new words.

Between 2 to 3 years, children:

  • begin to show a preference for using their right or left hand
  • scribble with a crayon or pencil
  • pour from a jug or carton
  • use the toilet with help
  • learn to ride a tricycle
  • know the names of familiar people
  • say their name
  • still have difficulty sharing and taking turns
  • are keen to do things for themselves, 'Me do it!'
  • begin to speak in short sentences
  • use the names of objects
  • copy the behaviour of others
  • clap in time to music
  • follow simple instructions
  • enjoy listening to stories
  • put together a simple puzzle.

Between 3 to 4 years, children:

  • walk and run
  • jump with feet together
  • ride a tricycle
  • can toilet themselves
  • begin to play cooperatively with other children
  • share and take turns sometimes
  • can listen and identify known sounds (cat, dog, vacuum cleaner)
  • can sing or say some songs and rhymes
  • ask endless questions but may not stay around to hear the answers
  • ask the meaning of new words
  • speak in short, clear sentences.

Between 4 to 5 years, children:

  • begin to ride a bicycle
  • balance on one leg
  • hop
  • hold a pencil between thumb and forefinger
  • can dress themselves except for tying shoe laces
  • develop more friendships, especially friends of the same sex
  • show some understanding of other people's feelings
  • answer questions clearly
  • give information and talk about past experiences, but may find it difficult to say what happened during the day when asked
  • tell stories, jokes and riddles (their jokes may not make sense to adults)
  • pass on messages
  • move from scribble to line drawings
  • enjoy making things out of 'odds and ends'
  • use the words 'and' and 'but'.

(Abridged list from: 'Growing and Learning in the Family: Children from birth to five years', Department of Education, Training and Employment, 1998)

If you are worried about your child's development, you should seek advice from your doctor or local child or community health staff. If necessary, these professionals will suggest a referral to specialists, such as a psychologist or paediatrician. Sometimes, parents may be referred to a special early intervention program to encourage their child's learning.

Preschool and school

Every person with an intellectual disability can learn and develop physically, mentally, socially and emotionally throughout life. However, learning may need more guidance, take more time and require more structure.

A child's rate of learning will depend upon the degree of intellectual disability present. Formal assessment can give parents and teachers some idea about a child's degree of intellectual disability from mild, moderate to severe.

Children with intellectual disability may find it hard to use their knowledge or skills in new situations. Skills and behaviours may have to be taught or re-taught in each place. For example, a child may learn to wash his hands at home. However, he may need help to learn to do the same task at preschool or school.

Children receive additional support at preschool or school depending upon their levels of need. Levels of need may vary depending upon abilities, environment, age and temperament. For instance, if your child relies heavily on routine and structure, she may be more settled in the classroom than in the school's playground.

Expectations can also make a difference to the amount of help your child may seem to need. You may find that your child is able to pack away her things at school but does not do so at home, because this has always been done by a parent or sibling.

Teachers and parents can help children with developmental delay and intellectual disability by:

  • using language that matches the child's understanding
  • giving extra time for new skills to be learned
  • allowing the child time and opportunities to practice new skills
  • presenting tasks in a step-by-step fashion
  • using predictable routines
  • making tasks as simple as possible
  • using teaching styles that allow the child to learn by touching and looking as well as by listening
  • being clear and consistent with expectations
  • identifying other supports and structures that help the child to participate in the home, school and community.

Resources

South Australia

 Disability Connect 
diSAbility connect is for parents and carers of children and young people with disability living in South Australia. It provides a gateway to help you to find information about your child’s disability and to existing information on programs, services, benefits and payments that may help you to care for your child. 
http://www.fahcsia.gov.au/disability-connect

Australia

  Better Start for Children with Disability initiative - funding and other assistance for eligible children. Some children with an intellectual disability will be eligible. Have a look at the FaHCSIA website for more information:
Better Start 

  • Association for Children with a Disability provides information, support and advocacy to families of children with a disability.
    http://www.acd.org.au/
  • Australian Society for the Study of Intellectual Disability aims to enhance the skills, knowledge and commitment of members and to facilitate a supportive network to improve the quality of life of people with intellectual or developmental disability.
    http://www.asid.asn.au/
  • Disability SA provides co-ordinated information, support and services.  

References

  • Annison, John. 'Disability: a guide for health professionals'. Thomas Nelson Australia, Melbourne, 1996.
  • Cocks, Errol. 'An introduction to intellectual disability in Australia'. 3rd edition, Australian Institute of Intellectual Disability, Canberra, 1989.
  • Gething, Lindsay. 'Person to person: a guide for professionals working with people with disabilities'. 3rd edition, MacLennan & Petty, Sydney, 1997.
  • Meyer, D J & Vadasy PF. 'Sibshops: workshops for siblings of children with special needs'. Paul Brookes, Baltimore, USA, 1994.
  • Porter, Louise. 'Professional collaboration with parents of children with disabilities'. MacLennan & Petty, Sydney, 2000.
  • Xingyan, Wen. 'The definition and prevalence of intellectual disability in Australia'. Australian Institute of Health and Welfare, Canberra, 1997.

Prepared in collaboration with
Department of Education, Training and Employment
Ministerial Advisory Committee on Students with Disabilities

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The information on this site should not be used as an alternative to professional care. If you have a particular problem, see a doctor, or ring the Parent Helpline on 1300 364 100 (local call cost from anywhere in South Australia).

This topic may use 'he' and 'she' in turn - please change to suit your child's sex.

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